Highlights
- •Forty-one determinants to using procedural pain treatments in infants and children were identified.
- •Previously known common barriers/facilitators to pediatric pain management are confirmed.
- •Unique determinants related to parents, organizational structures, culture were identified.
Abstract
Purpose
To explore nurse and physician leaders' perceptions of barriers and facilitators to
using evidence-based procedural pain treatments (i.e., sweet solutions, breastfeeding,
and topical anesthetics) for hospitalized infants and children in the Chinese context.
Design and methods
A descriptive qualitative study was conducted at three pediatric inpatient surgical
units in one hospital in China. Purposive sampling was used to recruit nurse/physician
leaders who were engaged in the clinical management of the 3 units. Data collection
included a focus group and individual interviews. The Consolidated Framework for Implementation
Research (CFIR) was used to guide the analysis of the data.
Results
Ten participants attended the focus group and 13 took part in individual interviews.
The findings highlight 41 implementation determinants, including two neutral influencing
factors, 22 barriers, and 17 facilitators. These influencing factors aligned with
the four CFIR domains and 25 of the 29 CFIR constructs. Common barriers to using evidence-based
pain treatments across different contexts were identified, such as health care professionals'
limited knowledge and misconceptions on pediatric pain management, no specific policies,
low priority, heavy workload, staff shortage, and limited time. Unique determinants
in the Chinese context were also identified, including parents' concerns of these
new interventions, parent wrath, hierarchical managerial system, and lower authority
of nurses.
Conclusions
Multiple barriers as well as facilitators to using evidence-based pain management
strategies were identified.
Practice implications
The findings inform further development of implementation strategies and could be
used as baseline data for comparing the barriers and facilitators evaluated during
and after implementation.
Keywords
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Article info
Publication history
Published online: June 22, 2020
Accepted:
June 9,
2020
Received in revised form:
June 5,
2020
Received:
February 18,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
